Managed Care Payors definition

Managed Care Payors shall have the meaning set forth in Section 3.7.
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Managed Care Payors shall have the meaning set forth in Section 3.9.
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Managed Care Payors means all managed care, institutional health care providers, health maintenance organizations, preferred provider organizations, Medicare, Medicaid, insurance companies and other similar persons or entities who contract for the professional medical services or for the provision of facilities or equipment at the Practice Sites.
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Examples of Managed Care Payors in a sentence

  • Administrator shall provide financial and business assistance to the Group in the negotiation, establishment, supervision and maintenance of contracts and relationships (collectively, the "Managed Care Contracts") with all managed care, institutional health care providers and payors, health maintenance organizations, preferred provider organizations, exclusive provider organizations, Medicare, Medicaid, insurance companies, hospitals and other similar persons (collectively, "Managed Care Payors").

  • Approval, disapproval, termination or amendment of any contract or relationship of such Managed Care Payors with the Group shall, after consultation with the Joint Planning Board, be the responsibility of the Group.

  • Administrator shall provide financial and business assistance to the Group Practice in the negotiation, establishment, supervision and maintenance of contracts and relationships (collectively, the "Managed Care Contracts") with all managed care, institutional health care providers and payors, health maintenance organizations, preferred provider organizations, exclusive provider organizations, Medicare, Medicaid and other similar persons (collectively, "Managed Care Payors").

  • Group shall maintain all existing Managed Care Contracts with Managed Care Payors, and any approval, disapproval, termination or amendment of any Managed Care Contract with any Managed Care Payor shall, after consultation with the Joint Planning Board, be the responsibility and obligation of Group, and Group shall act in a manner that is in the best business interests of the Professional Operations and the Technical Operations.

  • Medicaid contracts with these Managed Care Payors to provide coverage for these Medicaid eligible patients.

  • MCP shall negotiate, -------------------------------- establish, supervise and maintain all contracts and relationships (collectively, the "Managed Care Contracts") with all managed care and institutional healthcare providers and payors, health maintenance organizations, preferred provider organizations, exclusive provider organizations, Medicare, Medicaid and other similar entities (collectively, "Managed Care Payors").

  • Group shall maintain all existing Managed Care Contracts with Managed Care Payors, and any approval, disapproval, termination or amendment of any Managed Care Contract with any Managed Care Payor shall be the responsibility and obligation of the Joint Planning Board.

  • Medicare contracts with these Managed Care Payors to provide coverage for these Medicare eligible patients.

  • About the Future of Work Tripartite ForumThe Future of Work Tripartite Forum (the Forum), which first met in August 2018, is a partnership between the Government, Business New Zealand (as representatives of business groups) and the New Zealand Council of Trade Unions (as representatives of unions).

  • Group shall not terminate or amend any existing Managed Care Contracts with any Managed Care Payors without the prior written approval of PIP.


More Definitions of Managed Care Payors

Managed Care Payors has the meaning assigned thereto in Section 2.9.
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Related to Managed Care Payors

  • Managed care plan means a health benefit plan that either requires a covered person to use, or creates incentives, including financial incentives, for a covered person to use health care providers managed, owned, under contract with or employed by the health carrier.

  • Managed Care Plans means all health maintenance organizations, preferred provider organizations, individual practice associations, competitive medical plans and similar arrangements.

  • Medicaid means that government-sponsored entitlement program under Title XIX, P.L. 89-97 of the Social Security Act, which provides federal grants to states for medical assistance based on specific eligibility criteria, as set forth on Section 1396, et seq. of Title 42 of the United States Code.

  • Managed care entity means either a managed care organization licensed by the department of insurance (e.g., HMO or PHP) or a primary care case management program (i.e., MediPASS).

  • Managed care means a system that provides the coordinated delivery of services and supports that are necessary and appropriate, delivered in the least restrictive settings and in the least intrusive manner. Managed care seeks to balance three factors:

  • Third Party Payors means Medicare, Medicaid, CHAMPUS, Blue Cross and/or Blue Shield, private insurers and any other Person which presently or in the future maintains Third Party Payor Programs.

  • Managed care organization means an entity that (1) is under contract with the department to provide services to Medicaid recipients and (2) meets the definition of “health maintenance organization” as defined in Iowa Code section 514B.1.

  • TRICARE means, collectively, a program of medical benefits covering former and active members of the uniformed services and certain of their dependents, financed and administered by the United States Departments of Defense, Health and Human Services and Transportation, and all laws applicable to such programs.

  • Medicare The health insurance program for the aged and disabled established by Title XVIII of the Social Security Act (42 U.S.C. Sections 1395 et seq.) and any statute succeeding thereto.

  • HMO means any health maintenance organization, managed care organization, any Person doing business as a health maintenance organization or managed care organization, or any Person required to qualify or be licensed as a health maintenance organization or managed care organization under applicable federal or state law (including, without limitation, HMO Regulations).

  • Managed Care Organization (MCO) means a contracted health delivery system providing capitated or prepaid health services, also known as a Prepaid Health Plan (PHP). An MCO is responsible for providing, arranging, and making reimbursement arrangements for covered services as governed by state and federal law. An MCO may be a Chemical Dependency Organization (CDO), Dental Care Organization (DCO), Mental Health Organization (MHO), or Physician Care Organization (PCO).

  • Payors shall have the meaning set forth in Section 3.27.

  • Acute care hospital means a Hospital that provides Acute Care Services. Adjudicate means to deny or pay a Clean Claim. Administrative Services see MCO Administrative Services. Administrative Services Contractor see HHSC Administrative Services Contractor.

  • Health care facility or "facility" means hospices licensed

  • Primary care physician or “PCP” means a Plan Provider who has an independent contractor agreement with HPN to assume responsibility for arranging and coordinating the delivery of Covered Services to Members. A Primary Care Physician’s agreement with HPN may terminate. In the event that a Member’s Primary Care Physician’s agreement terminates, the Member will be required to select another Primary Care Physician.

  • Third Party Payor means Medicare, Medicaid, TRICARE, and other state or federal health care program, Blue Cross and/or Blue Shield, private insurers, managed care plans and any other Person or entity which presently or in the future maintains Third Party Payor Programs.

  • Pharmacy means prescribed drugs and medicines dispensed by a pharmacist and/or travel and allergy vaccines dispensed by a pharmacist or doctor.

  • Medicare Advantage The Medicare managed care options that are authorized under Title XVIII as specified at Part C and 42 C.F.R. § 422.

  • Third Party Payor Programs means all third party payor programs in which Tenant presently or in the future may participate, including, without limitation, Medicare, Medicaid, CHAMPUS, Blue Cross and/or Blue Shield, Managed Care Plans, other private insurance programs and employee assistance programs.

  • Medicare Provider Agreement means an agreement entered into between CMS or other such entity administering the Medicare program on behalf of CMS, and a health care provider or supplier under which the health care provider or supplier agrees to provide services for Medicare patients in accordance with the terms of the agreement and Medicare Regulations.